Empow ASC Waiting List
Parent's first & last name
Your answer
Phone number
Your answer
Email address
Your answer
Which school years are you hoping to sign up for?
Required
How many children are you hoping to register?
Child's name(s)
Your answer
What days were you hoping to sign up for?
Required
What date would you like to start?
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DD
/
YYYY
Do you have any questions about the After-School Club that we can help clarify?
Your answer
Would you like to join our e-newsletter?
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